How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $50.12 Typical High $50.12 | Professional | None | $41.69 | $50.12 | $50.12 |
BCBS Arkansas Setting Professional Modifier None Typical Low $77.62 Median $85.11 Typical High $102.33 | Professional | None | $77.62 | $85.11 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $72.44 | Facility | None | $56.23 | $56.23 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $40.74 Typical High $56.23 | Professional | None | $28.18 | $40.74 | $56.23 |
United Setting Facility Modifier None Typical Low $91.20 Median $107.15 Typical High $107.15 | Facility | None | $91.20 | $107.15 | $107.15 |
United Setting Professional Modifier None Typical Low $30.20 Median $41.69 Typical High $61.66 | Professional | None | $30.20 | $41.69 | $61.66 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.99 Median $24.55 Typical High $24.55 | Professional | 52 · Reduced service | $23.99 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $10.00 Typical High $10.00 | Professional | 53 · Discontinued | $9.55 | $10.00 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.41 Typical High $7.41 | Professional | 55 · Aftercare only | $7.24 | $7.41 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.01 Typical High $5.01 | Professional | 56 · Pre-op care only | $4.79 | $5.01 | $5.01 |
Where Arkansas sits
The same service costs 3.1 times more in Hawaii than in Kansas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Arkansas· 10th of 51
$77.62
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.